Your Brain Doctor

 

Intellectual Developmental Disorder Severity levels From DSM-5 TR 

1. Severity level : Mild

Conceptual domain:

Preschool children:

No obvious conceptual differences

School-age children and adults:

Difficulties in learning academic skills
Need for support in one or more areas to meet age-related expectations

Adults:
Impairment in abstract thinking
Executive function deficits (i.e., planning, strategizing, priority setting, and cognitive flexibility)
Short-term memory impairment
Impairment in functional use of academic skills (e.g., reading, money management)
Somewhat concrete approach to problems and solutions compared with age-mates

Social domain:

Social interactions:

Immaturity in social interactions compared with typically developing age-mates
Difficulty in accurately perceiving peers' social cues

Communication and language:

Communication, conversation, and language are more concrete or immature than expected for age

Emotional regulation and behavior:

Difficulties in regulating emotion and behavior in an age-appropriate fashion
Difficulties noticed by peers in social situations

Social judgment:

Limited understanding of risk in social situations
Immature social judgment for age
At risk of being manipulated by others (gullibility)

Practical domain:

Personal care:

The individual may function age-appropriately in personal care

Daily living tasks:

Need for support with complex daily living tasks in comparison to peers
Supports in adulthood involve grocery shopping, transportation, home and child-care organizing, nutritious food preparation, and banking and money management

Recreational skills:

Recreational skills resemble those of age-mates
Judgment related to well-being and organization around recreation requires support in some cases

Employment:

Competitive employment often seen in jobs that do not emphasize conceptual skills
Individuals generally need support to learn to perform a skilled vocation competently

Family and legal decisions:

Support is typically needed to raise a family

Support is typically needed to make health care and legal decisions

2. Severity level : Moderate

Conceptual domain:

Preschoolers:

Slow development of language and preacademic skills

School-age children:

Slow progress in reading, writing, mathematics, and understanding of time and money across school years

Markedly limited academic skill development compared with peers

Adults:

Academic skill development typically at an elementary level

Support required for all use of academic skills in work and personal life

Daily life:

Ongoing assistance on a daily basis needed to complete conceptual tasks of day-to-day life

Others may take over these responsibilities fully for the individual

Social domain:

Spoken language:

Spoken language is typically a primary tool for social communication

Spoken language is much less complex than that of peers

Relationships:

Capacity for relationships is evident in ties to family and friends

The individual may have successful friendships across life and sometimes romantic relations in adulthood

Social cues and judgment:

Individuals may not perceive or interpret social cues accurately

Social judgment and decision-making abilities are limited, and caretakers must assist the person with life decisions

Interactions with peers:

Friendships with typically developing peers are often affected by communication or social limitations

Significant social and communicative support is needed in work settings for success.

Practical Domain:

Personal Care

The individual can care for personal needs such as eating, dressing, elimination, and hygiene as an adult.

However, an extended period of teaching and time is needed for the individual to become independent in these areas, and reminders may be needed.

Household Tasks

Participation in all household tasks can be achieved by adulthood.

However, an extended period of teaching is needed, and ongoing support will typically occur for adult-level performance.

Employment

Independent employment in jobs that require limited conceptual and communication skills can be achieved.

But considerable support from coworkers, supervisors, and others is needed to manage social expectations, job complexities, and ancillary responsibilities such as scheduling, transportation, health benefits, and money management.

Recreational Skills

A variety of recreational skills can be developed.

These typically require additional support and learning opportunities over an extended period of time.

Maladaptive Behavior

Maladaptive behavior is present in a significant minority and causes social problems.

3. Severity Level: Severe

Conceptual Domain:

Limited Attainment of Conceptual Skills:

The individual has limited understanding of written language and concepts related to numbers, quantity, time, and money.

Extensive Support Needed for Problem Solving: 

Caretakers provide extensive support for problem solving throughout life.

Social Domain 

Communication Skills:

Limited Vocabulary and Grammar

Use of Augmentative Communication

Social Interaction:

Focus on Everyday Events

Limited Understanding of Social Cues
Pleasure and Help from Family and Familiar Others

Practical Domain

Personal Care:

Support needed for all activities of daily living

Includes meals, dressing, bathing, and elimination
Requires supervision at all times

Decision-making:

Cannot make responsible decisions regarding self or others

Household tasks:

Ongoing support and assistance needed for participation in tasks at home, recreation, and work

Skill Acquisition:

Long-term teaching and ongoing support required for skill acquisition in all domains

Maladaptive Behavior:
Present in a significant minority, including self-injury.

4. Severity level : Profound

Conceptual Skills:

Limited to the physical world rather than symbolic processes.

Object use is goal-directed for self-care, work, and recreation.
Visuospatial skills, such as matching and sorting based on physical characteristics, may be acquired.

Motor and Sensory Impairments:

Co-occurring motor and sensory impairments may prevent functional use of objects.

Social domain

The individual has very limited understanding of symbolic communication in speech or gesture.

Capacity for relationships

He or she may understand some simple instructions or gestures.

Expression of desires and emotions

The individual expresses his or her own desires and emotions largely through nonverbal, nonsymbolic communication.

Relationships

The individual enjoys relationships with well known family members, caretakers, and familiar others, and initiates and responds to social interactions through gestural and emotional cues.

Sensory and physical impairments

Co-occurring sensory and physical impairments

may prevent many social activities.

Practical Domain:

Daily Living Skills:

Dependence on Caregivers for All Aspects of Physical Care, Health, and Safety

Limited Participation in Daily Work Tasks at Home
Support Needed for Basic Vocational Activities

Recreational Activities:

Limited Participation in Recreational Activities

Enjoyment in Simple Activities with Support of Others
Co-occurring Physical and Sensory Impairments as Barriers

Maladaptive Behavior:

Presence of Maladaptive Behavior in a Significant Minority